2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12B.01 Weight Gain and Metabolic Changes Associated with Alectinib Use in ALK-Positive Lung Cancer

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The study examines weight gain and metabolic changes associated with alectinib, a second-generation ALK-targeting tyrosine kinase inhibitor (TKI) for ALK-positive non-small cell lung cancer (NSCLC). It uses a retrospective cohort design, comparing ALK-positive patients treated with alectinib against EGFR-mutated patients treated with the TKI osimertinib. As alectinib's systemic and central nervous system effectiveness improves survival in ALK-mutated NSCLC, the study aims to better understand its long-term health impacts, especially considering weight gain and metabolic alterations.<br /><br />Key findings reveal that after 12 months on treatment, alectinib patients experienced a mean weight gain of 7.3% and a 1.61-fold BMI increase. This contrasted with a 0.8% weight decrease in osimertinib patients, with a 0.12-fold BMI decrease, marking a significant difference in weight gain between both therapies (p < 0.001). Following controlled adjustments for comorbidities like diabetes, hypertension, dyslipidemia, and smoking status, alectinib patients showed a significantly higher propensity for grade 2 or more significant weight gain, with an odds ratio of 7.07 compared to osimertinib patients.<br /><br />The results point toward a need for prospective evaluation of long-term metabolic complications associated with alectinib to optimize treatment selections and survivorship for ALK patients. Despite the pronounced weight gain, no significant differences were noted in metabolic markers like LDL cholesterol or Hemoglobin A1c between the two patient groups, suggesting that weight gain may occur independently of these metabolic factors. Consequently, the findings are essential for guiding long-term management strategies in the treatment of ALK-positive NSCLC.

Asset Subtitle

Jay Maturi

Meta Tag

Speaker Jay Maturi

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

alectinib

weight gain

metabolic changes

ALK-positive NSCLC

tyrosine kinase inhibitor

osimertinib

retrospective cohort

BMI increase

long-term health impacts

treatment strategies